CHILD AND ADULT CARE FOOD PROGRAM
ALIGNING DIETARY GUIDANCE FOR ALL
Suzanne P. Murphy, Ann L. Yaktine, Carol West Suitor, and Sheila Moats, Editors
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by Contract No. AG-3198-C-08-0001 between the National Academy of Sciences and the U.S. Department of Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Suggested citation: IOM (Institute of Medicine). 2011. Child and Adult Care Food Program: Aligning Dietary Guidance for All. Washington, DC: The National Academies Press.
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Advisers to the Nation on Science, Engineering, and Medicine
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COMMITTEE TO REVIEW CHILD AND ADULT CARE FOOD PROGRAM MEAL REQUIREMENTS
SUZANNE P. MURPHY (Chair),
Cancer Research Center of Hawaii, University of Hawaii, Honolulu
NORMA D. BIRCKHEAD,
District of Columbia Office of the State Superintendent of Education, Washington, DC
ALICIA L. CARRIQUIRY,
Department of Statistics, Iowa State University, Ames
Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System; Arkansas Geriatric Education Center, University of Arkansas for Medical Sciences, Little Rock
Teaching and Mentoring Communities, Laredo, TX
KAREN WEBER CULLEN,
Children’s Nutrition Research Center, Baylor College of Medicine, TX
MARY KAY FOX,
Mathematica Policy Research, Inc., Cambridge, MA
Food Research and Action Center, Washington, DC
HELEN H. JENSEN,
Department of Economics, Iowa State University, Ames
Connecticut Department of Education, Middletown
VIRGINIA A. STALLINGS,
The Children’s Hospital of Philadelphia, University of Pennsylvania
KATHERINE L. TUCKER,
Department of Health Sciences, Northeastern University, Boston, MA
ANN YAKTINE, Study Director
SHEILA MOATS, Associate Program Officer
JULIA HOGLUND, Research Associate
HEATHER BREINER, Program Associate
ANTON BANDY, Financial Officer
GERALDINE KENNEDO, Administrative Assistant,
Food and Nutrition Board
LINDA D. MEYERS, Director,
Food and Nutrition Board
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Denise M. Brown, Department of Nutrition and Food Systems, The University of Southern Mississippi, Hattiesburg
Jean Charles-Azure, Indian Health Service, Rockville, MD
Barbara L. Devaney, Mathematica Policy Research, Inc., Princeton, NJ
Craig Gundersen, Department of Agriculture and Consumer Education, University of Illinois, Urbana
James O. Hill, Center for Human Nutrition, Colorado Clinical Nutrition Research Unit, Denver
Nancy F. Krebs, Department of Pediatrics, Section of Nutrition, University of Colorado, Denver
Joanne R. Lupton, Department of Nutrition and Food Science, Texas A&M University, College Station
Sandra J. Rhoades, Division of Nutrition, New York State Department of Health, Albany
Nancy S. Wellman, Department of Dietetics and Nutrition, Florida International University, Miami
Walter C. Willett, Department of Nutrition, Harvard School of Public Health, Boston, MA
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Eileen Kennedy, Friedman School of Nutrition Science and Policy, Tufts University, and Jeanne Brooks-Gunn, Teachers College and College of Physicians and Surgeons, Columbia University. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
The Child and Adult Care Food Program (CACFP) is a U.S. Department of Agriculture (USDA) food program that is not well-known to either the general public or nutrition professionals. I must admit that I knew little about this program before the Committee to Review CACFP Meal Requirements began its work. I did not know that CACFP
Serves almost 3 million children and adults,
Has participants ranging in age from small infants to elderly adults, and
Can provide over half of the day’s calories for some participants through two meals and a snack, or two snacks and a meal.
Over the past year, as the committee carried out its tasks, my knowledge and appreciation for CACFP have grown enormously. Several members of the committee, including me, had served as members of the authoring committees for two other recent reviews of USDA’s food programs: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the National School Lunch and Breakfast Programs. However, we still had much to understand about the uniqueness of CACFP. In this process, we were guided and informed by the expertise of committee members with many years of experience with the program. The resulting report was truly a team effort by experts from many disciplines: nutrition, epidemiology, statistics, economics, and food program implementation. I think I speak for the whole committee in saying it has been a very rewarding experience to participate in the review of the CACFP meal requirements. We hope that the
resulting recommendations will help to make this excellent food program even better. Furthermore, given the broad scope of CACFP, these recommendations should be applicable across all age groups, and thus effectively align dietary guidance for all Americans.
The committee could not have done its work without the tireless efforts of the Institute of Medicine study team. The Study Director, Ann Yaktine, kept us focused and on time, and contributed substantially to the writing effort. She was assisted by an able team, including Sheila Moats, Associate Program Officer, who assisted with food pattern analysis; Julia Hoglund, Research Associate, who assisted with the cost analysis and research support; and Heather Breiner, Program Associate, who managed program logistics. Linda Meyers, the Director of the Food and Nutrition Board, provided us with wise advice at crucial points in our deliberations. Last, but certainly not least, Carol Suitor joined us as a consulting editor during the writing phase and made extensive contributions to the final report. I am grateful to all of them.
Other people made important contributions to the many analyses that were necessary for the report. Todd Campbell from Iowa State University developed the software that was used to determine the costs and helped with assigning codes to foods for the purpose of nutrient analyses, and Janice Maras from Northeastern University assisted with the menu analyses. In addition, we held an open session at our second meeting, and we heard from both the CACFP program administrators at the Food and Nutrition Service at USDA and from others with expertise relevant to the committee’s task. Our thanks go to all who contributed to our deliberations.
Finally, as chair, I would like to express my sincere appreciation to the committee members for their commitment to making the report scientifically accurate as well as realistic and practical. The committee added this volunteer effort to their full-time jobs, and that often required working nights and weekends. I thank them for their time and many contributions. It was a pleasure working with each of them.
Suzanne P. Murphy, Chair
Committee to Review Child and Adult Care Food Program Meal Requirements